Table 27Decision rules built into the simulation model

BlockageRule
AMU is full1. Move the patient that has the least time remaining in the AMU, NEWS<5 and GMW as their next destination to the GMW
2. Look in the queues for rehab or care home if anyone is waiting and holding AMU bed, move them temporarily to a GMW bed
GMW is full1. Discharge patient early from GMW who is within 24 hours of discharge, has NEWS <5 and is not being newly discharged to care home
2. Move patient who is between 24-72 hours of their GMW length of stay and has NEWS <5 to medical outlier
3. Move new incoming patient to medical outlier.
ICU is full1. Move patient from ICU to GMW if they are in last 12 hours of ICU stay and are destined to move to GMW or rehab
HCU is full1. Move patient from HCU to GMW if they are in last 12 hours of HCU stay and are destined to move to GMW or rehab and NEWS <5
2. New HCU patient can move to ICU but must move on when ‘true ICU’ patient needs bed
Rehab is fullPatient has to wait for a bed to become available.
Medical outliers has reached maximumQueues will build up in ED as the hospital is full.

From: Chapter 41, Cost-effectiveness analyses

Cover of Emergency and acute medical care in over 16s: service delivery and organisation
Emergency and acute medical care in over 16s: service delivery and organisation.
NICE Guideline, No. 94.
National Guideline Centre (UK).
Copyright © NICE 2018.

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